Approaching safety holistically

Why do certain workers – low income, minorities, immigrants, younger, older – have a higher risk for injuries and illnesses in the workplace, and what can be done to reduce the disparities?

These questions were the central focus of NIOSH’s first conference on “Eliminating Health and Safety Disparities at Work,” which took place Sept. 14-15 in Chicago. The event drew about 250 attendees representing labor and community groups; academics; employers; and state, federal and local health departments.

That same week, the Census Bureau reported that a record 46.2 million Americans were living in poverty in 2010.

“I think what we’re seeing is that the economy is shifting so that an ever-increasing proportion of workers find themselves in situations that we tried to address in the conference,” said Sherry Baron, coordinator for occupational health disparities at NIOSH.

Baron noted in an interview with Safety+Health that low-income and minority employees often work in high-hazard industries and, given the fragile economy, they may fear job loss if they report safety and health concerns. Some of these workers spoke up during a panel discussion: a hotel employee on strike for better working conditions, a home health care worker whose employer did not provide adequate personal protective equipment, and a restaurant worker whose employer showed indifference when she was injured.

Research was a focal point of the conference, with attendees discussing white papers on topics such as workplace discrimination, work organization and training.

Dori Rose Inda participated in a session that discussed the effects of social, economic and labor policies on occupational health disparities.

“To me, what is really most valuable is pulling all that information, that history, the policies and the data together,” she said. “As far as I know, that hadn’t been done before.”

Inda is founder and executive director of the nonprofit Watsonville Law Center in Watsonville, CA, which offers free legal services to injured workers and low-income individuals. NIOSH’s emphasis on inequities and job insecurity fits with her experience at the center, where many of the clients are Latino immigrants.

“I think what we’ve seen are people more hesitant to report and more hesitant to take care of themselves for fear of both job loss and retaliation,” Inda said.

Inside and outside the workplace

Baron, co-author of a paper on integrating public health and occupational health approaches, emphasized the importance of addressing the various systems – inside and outside the workplace – that contribute to disparities. She offered an example of an employee suffering from asthma. If the employee is exposed to a solvent at work, as well as something in the atmosphere at home that is aggravating the condition, then both exposures need to be addressed.

“In general, there’s a challenge for us as public health workers to think more holistically about exposures,” she said. “If we just compartmentalize exposures into work and non-work, we may miss opportunities to develop more comprehensive prevention programs.”

Employers also realize the need to address language and cultural issues that may lead to differences in exposure to safety hazards.

“Many employers have tried to make efforts to recognize the diversity of the workforce and to recognize that training programs, to be effective, have to better reach the full spectrum of workers – whether it’s an issue of literacy, language, previous knowledge about safety and health, a whole host of reasons,” Baron said.

Interrelated hazards

During another session, representatives from OSHA, the Environmental Protection Agency, and the Department of Health and Human Services described the ongoing effort to develop programs to reduce disparities as part of the Federal Interagency Working Group on Environmental Justice, which was created in 1994. The interagency initiative highlights a point reiterated during the conference – injustices tend to occur together. For example, a worker in an unsafe job may come home to a community plagued by environmental pollution, or an employer may be in violation of OSHA, wage and hour, and environmental regulations.

“I think there is increasing recognition of the interrelatedness of issues,” Baron said.

Baron believes issues discussed during the conference, such as developing appropriate training for various populations and the impact of job insecurity on workplace safety programs, should be addressed at other conferences as well.

“I think the questions that we raised are important issues and will come up whether or not there is a conference specifically devoted to it,” she said. “I think, ideally, what we’d like is for these issues to become part of what we think about when we try and comprehensively address safety and health problems.”

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